Surgical table



June 26, 1962 E. R WEICKGENANNT ETAL 3,041,119

SURGICAL TABLE v 3 Sheets-Sheet 1 Filed Sept. 22, 1960 Fig. 2

INVENTORS. EGON R. WEICKGENANNT GEORG E. MART/N fl W AT 017N575 June 26, 1962 E. R. NEICKGENANNT ETAL SURGICAL TABLE 3 Sheets-Sheet 2 Filed Sept. 22, 1960 INVENTORS. EGON R. WE/CKGENANNT GEORGE E. MARTIN BY W Y M v W ATTORNEYS atent 3,641,119 Patented June 26, 1962 3,041,119 SURGIQAL TABLE Egon R. Weickgenannt, Rochester, and George E. Martin,

Scotia, N.Y., assignors to Ritter Company, Inc, Rochester, N .Y a corporation of Delaware Filed Sept. 22, 1960, Ser. No. 57,657 Claims. (Cl. 311-7) This invention relates to surgical tables. Reference is made to the copendihg application of George Martin, Egon Weickgenannt and Karl Burzlaff filed on or about September 19, 1960, for a detailed discussion of the table shown herein.

The table to which our invention is applied is unique in that five sections are provided: a headrest section, a spinal or backrest section, a pelvic or seatrest section, a femoral or upper legrest section, and a lower legrest section. The invention herein disclosed is con cerned with the articulation between the spinal or back section and the pelvic or seat section.

An object of our invention is to provide a novel articulation between two sections of a sectionalized table.

Another object of our invention is to provide in a sectionalized table, a back or spinal section which may be swung through a large angle with respect to the pelvic or seat section.

Our invention is further concerned in a sectionalized table, with the rigidity and stability of the back or spinal section when swung to its extreme upper and lower angular relations with respect to the pelvic or seat section.

More specifically our invention contemplates shifting the fulcrum, in a sectionalized table, about which the back or spinal section swings with respect to the pelvic or seat section to the end that when the spinal section is swung to its extreme upper and lower angular relations with respect to the pelvic section, the spinal section is rigid and stable and undue stress on the supporting parts is avoided.

Other objects and advantages of this invention will be set forth in the claims and will be apparent from the following description, when taken in connection with the accompanying drawings, in which:

FIG. 1 is a top plan view of a major surgical table constructed according to one embodiment of this invention and in which the invention of this application is incorporated;

FIG. 2 is a side elevation of FIG. 1;

FIG. 3 is a side elevation of the spinal or back section of the table, showing the actuating mechanism therefor, and showing in dotted lines the extreme lowered position and the extreme raised position of the section with respect to the pelvic section; and

FIG. 4 is a complete hydraulic diagram used in controlling the table and the sections thereof.

The surgical table of this invention comprises a table having a table surface, generally indicated by the numeral 31, for the reception of the patient. The metal table surface is adapted to receive one or more cushions (not shown) for the comfort of the patient. The table includes base 32 from which the table surface is supported; a pump and motor housing, generally indicated by the numeral 33; a control box, generally indicated by the numeral 34, which houses the valves for actuating the various hydraulic mechanisms; and a plurality of control handles, in thi case five, for separately controlling each of the operations of raising and lowering the spinal and femoral sections with rmpect to the plevic section, raising and lowering the table surface 31 as a whole and laterally and longitudinally tilting the table.

The base 32 is mounted on four casters 37 which are provided with locking means (not shown) to hold the casters against movement when the table is in use, as shown and particularly described in Karl H. Burzlaff application Ser. No. 777,870 filed December 3, 1958.

A pedestal or support column, generally indicated by the numeral 38, is mounted on the base 32 and supports the table or table surface 31. The table comprises five sections: a headrest section 39, a spinal or back section 41, a pelvic or seat section 42, a femoral or upper legrest section 43, and a lower legrest section 44.

The headrest section 39 is manually operated, as presently will appear, the spinal section is operated by a hydraulic piston and cylinder assembly, generally indicated by the numeral 46, and the femoral section 43 is operated by a hydraulic piston and cylinder assembly generally indicated by the numeral 47. The purposes and advantages of a five section table will be fully described and claimed in a separate application presently to be filed.

Referring now to FIG. 4 the table 31 is raised and lowered by a hydraulic piston and cylinder assembly, indicated generally by the numeral 48. Lateral tilt of the table about its longitudinal axis is accomplished by a cylinder and piston assembly, indicated by the numeral 4-9. Movement of the table to Trendelenburg or reverse Trendelenburg positions, that is, pivoting the table about a horizontal transverse axis, is accomplished by a piston and cylinder assembly 51.

Upon reference to the hydraulic system, schematically shown in FIG. 4, and by reference to the above mentioned application, it is believed that the general operation of the table will be clear. Housed in the control box, generally indicated by the numeral 34 are five valve assemblies: a table elevating and lowering valve assembly 52; a Trendelenburg and reverse Trendelenburg valve assembly 53; a femoral valve assembly 54; a back or spinal valve assembly 56; and a lateral tilt valve assembly 57. Each of the hand controls 36 has a neutral central position, a forward position and a back position.

It is suflicient for an understanding of the present invention to state that when the handle 36 associated with the table elevating valve 52 is pulled rearward from its central neutral position, oil is supplied to the bottom of the elevating cylinder 48 to urge the piston therein in an upward direction. Simultaneously oil is exhausted from the top of the elevating cylinder 48 and returned to a sump or oil reservoir 69. Similarly with the valves 53, 54, 56 and 57. When the handle corresponding to each of these valves is pulled rearward, oil is supplied respectively to the top of the Trendelenburg cylinder 51, the bottom of the femoral cylinder 47, the bottom of the spinal or back cylinder 46, and the bottom of the lateral tilt cylinder. Simultaneously the upper or lower ends of these cylinders are connected to the exhaust or oil sump 69. Reverse movement of the handles reverses the direction of oil flow.

-In FIG. 4 the motor and pump, having been indicated respectively by the letters M and P, pressure limit cutoff valves by the numeral 150, a pressure relief valve by the numeral 145, hydraulic bellows by the numerals 152 and 154 and a micro-switch by the numeral 157 and a vent 155 for the system. The lines to these elements may be readily traced by those skilled in the art. In the event of power failure, a hand pump may be connected at the connections 105.

It is suificient for an understanding of the hydraulic system for the purposes of the present invention to understand that oil may be supplied to either side of the spinal cylinder 46 and simultaneously oil is exhausted from the other side of the piston operating within the cylinder 46 to shift the spinal section 4 1 from the solid line position of FIG. 3 to either of the dotted positions or any intermediate position.

Referring now to FIGS. 1 and 2, the table includes side rails 261, 262 and 263 on each side of the table. The side rails are rigidly secured to the various sections by means indicated at 2 54. These side rails are for the purpose of adjustably holding clamps for arm rests, leg rests or stirrups, an anesthetic screen or Other removable accessories with which the table may be equipped. Between the pelvic section 42 and the spinal section 41, these side rails are overlapped and formed with openings to receive hinge pins 266 on opposite sides of the table. These hinge pins form the articulated joint or hinge generally indicated by the numeral 58 in FIG. 3, the hinge pins being shown at 266 in the same view.

In FIG. 3, the mechanism for raising or lowering the spinal or back section 41 about the pelvic or seat section 42 has been shown and is the subject of this application. This swinging movement occurs about the hinge axis 523 or hinge pins 266. The hydraulic connections to the spinal cylinder 46 are illustrated in FIG. 4 in a diagrammatic manner and these connections are not shown in FIG. 3 for the purpose of simplifying this view. The piston (not shown) of the spinal cylinder 46, has a piston rod 271 rigidly connected thereto, the end of which is bifurcated and pivoted on a hinge pin 272 carried by a bracket, indicated at 273, depending below the spinal section 41.

Normally when the spinal section 41 (FIG. 2) and the femoral section 43 are in a horizontal position with respect to the pelvic section 42, their cylinders 46 and 47 are filled with oil about equally on both sides of their pistons. When oil under pressure is admitted to the lower end of the spinal cylinder 46, the pressure actuates the piston within the cylinder 46 and simultaneously, oil is exhausted from the upper side of the cylinder and returned to the sump '69 (FIG. 4). This action moves the spinal section 41 about the pivot joint 58 to the upper dotted line position shown in FIG. 3. In this View we have shown the limit of the upward movement of the spinal section 41 but it will be understood that any intermediate position from the solid line position of FIG. 3 to the upper dotted line position of the same view, is possible.

When oil under pressure is applied to the top side of the piston within the spinal cylinder 46 and exhausted from the underside thereof, the spinal section 41 is swung to the lower dotted line position of FIG. 3 or any intermediate position between the solid line position and the lower dotted line position.

It will be noted from FIG. 3 that the spinal section 41 can be swung downward through a total angle of approximately 50. The upward angular movement of the spinal section with respect to the pelvic section should be preferably somewhat larger. As shown in the drawings the spinal section may be swung through an angle from the horizontal of approximately 60. This increased angle of movement is desirable in some surgical operating positions. In the extreme upward position of the spinal section shown in FIG. 3, the weight of the patient on the back or the spinal section 41 places an undue strain upon the mechanism for supporting the spinal section. To avoid strain on the supporting means of the spinal section, a unique movable support is provided.

For the above purposes, a bracket 27 6 is supported from the underside of the pelvic section 4-2 by means of bolts 277. The bracket 276 has a pair of horizontally extending roller guides or ways 278. The roller guides 278 are adapted to receive rollers 279 carried by roller pins 281. The roller pins are rigid with a pair of depending plates 282. A pivot shaft 283 extends through openings formed on the lower ends of the plates 282 and through an opening in a partial gear 234. On the shaft 283 are suitable means, for spacing the parts and holding them in assembled relation. The partial gear 284 is rigidly mounted on the sidewall of the spinal cylinder 46 as by welding or in any other suitable manner.

Mounted on and rigidly secured to the bracket 276 is a rack 287 which meshes with the partial gear 2S4. In FIG. 3, we have indicated a solid and two dotted line positions for the plates 282 and, hence, for the shaft 283.

It will now be appreciated that as the spinal section 41 is swung from the solid line position in an upward direction, the rollers 279 ride to the left in the roller guides 27%, as viewed in FIG. 3. The fulcrum point of the leverage system thus described, comprising the spinal section and the support therefor is the shaft or pivot pin 283. During the upward movement of the spinal section, the shaft 283 moves from the solid line position of FIG. 3 to the dotted line position. Since the fulcrum point has been moved to the left as viewed in FIG. 3, the leverage supporting the spinal section is such that possibility of collapse of the spinal section is eliminated and strain on the parts is minimized. The spinal section is rigidly supported in the upper dotted line position of FIG. 3.

When the spinal section is swung down to the dotted line position of FIG. 3, shaft or pivot pin 283 moves to the right, as indicated in FIG. 3, of its normal solid line position. This also increases the leverage supporting the spinal section in its downward dotted line position. As shown, the amplitude of downward movement of the spinal section is decreased because extreme movement of the spinal section in the downward direction is unnecessary.

One of the major advantages of our invention is that the underside of the table is free from gears or obstructions of any kind and therefore it is posible to swing the spinal section in relation to the pelvic section in a downward direction through an arc of 50. In some present commercial tables the back section cannot be swung downward more than a few degrees because of the presence of shafts, gears, hand controls and other obstructions beneath the back section.

While a downward swinging movement of 50 is unnecessary in surgical operations a downward swinging movement in excess of that afforded by present tables is important. For example, in kidney operations and in some chest operations, it is necessary to lay the patient on his side and adjust the table so that the area of the patient above the kidney is stretched for greater exposure. Because the spinal section may swing downward to any extent which may be desired by the surgeon maximum exposure of the kidney area may be attained. A kidney bridge, with its attendant localized pressures, is unnecessary.

While we have shown and described the preferred form of our invention, it will be apparent that various changes may be made, particularly in the form and relation of the parts, without departing from the spirit of our invention as set forth in the appended claims.

We claim:

1. A surgical table or the like comprising, in combination, a plurality of table sections operatively connected together, one of said table sections being a spinal section and another :being a pelvic section, means for articulating said spinal section with respect to said pelvic section and means for shifting the point of support of the spinal section toward the head end of the table as the spinal section is swung upward with respect to the pelvic section.

2. A surgical table or the like in accordance with claim 1 in which said last mentioned means includes a rack and a segmental gear.

3. A surgical table or the like comprising, in combination, a plurality of table sections operatively connected together, one of said table sections being a spinal section and another being a pelvic section, means for pivoting said spinal section with respect to said pelvic section, a

hydraulic cylinder element and a hydraulic piston element operable in said cylinder element, one of said elements being pivoted on said spinal section and the other of said elements being pivoted with respect to said pelvic section and means for shifting said latter pivot toward the head end of the table when the spinal section is swung upward about said spinal section pivot.

4. A surgical table or the like in accordance with claim 3 wherein said last mentioned means comprises a rack carried by the spinal section and a gear mounted on one of said elements.

5. A surgical table or the like comprising, in combination, a plurality of table sections operatively connected together, one of said sections being a spinal section and another of said sections being a pelvic section, said sections having side rails and pivot pins extending through said side rails and pivotally connecting the spinal section to the pelvic section.

6. A surgical table or the like in accordance with claim 5 in which a support is provided for the spinal section including a hydraulic cylinder and piston and a fulcrum and means are provided for shifting the fulcrum toward the head end of the table when the spinal section is swung upward around said pivots.

7. A surgical table or the like comprising, in combination, a plurality of table sections operatively connected together, means for pivotally connecting two of said sections together for swinging movement of one section with respect to the other, connections including a fulcrum between said sections for supporting the swinging section from the other section and means for shifting said fulcrum to increase the support for said swinging section either when swung upward or downward from the horizontal.

8. A surgical table or the like in accordance with claim 7 in which part of said last mentioned means is a hydraulic cylinder and piston assembly.

9. A surgical table or the like comprising, in combination, a plurality of table sections operatively connected together, means for articulating two of said sections for swinging movement of one section with respect to the other, connections including a fulcrum between said sections for supporting the swinging section from the other section, means for shifting said fulcrum during the swinging movement to increase the support for said swinging section when swung upward, the underside of said swinging section being free of obstructions interfering with the free swinging of said section and power actuated means including connections between said sections for swing-ing said section.

10. A surgical table or the like comprising, in combination, a plurality of table sections operatively connected together, means for swinging a first section with respect to a second section to an upwardly or downwardly angular position with respect to the plane of said second section comprising a piston element and a cylinder element, one of said elements being pivoted with respect to the first section and the other of said elements being pivoted with respect to the second section, the element connected to the second section having a pivot axis, means for shifting said pivot axis longitudinally of the plane of the second section as the first section is swung with respect to the second section and means for supplying said piston and cylinder elements with fluid under pressure.

References Cited in the file of this patent UNITED STATES PATENTS 2,172,941 Manning Sept. 12, 1939 2,217,783 Bell Oct. 13, 1940 2,520,455 Clachko Aug. 29, 1950 2,571,829 Buckley Oct. 16, 1951 2,647,026 Shampaine July 28, 1953 2,794,694 Fullwood et a1. June 4, 1957 FOREIGN PATENTS 681,858 Germany Oct. 3, 1939 1,054,664 Germany Apr. 9, 1959 

